A randomized trial of exercise therapy in patients with acute low back pain. Efficacy on sickness absence

Abstract

Study design: A randomized, placebo-controlled trial in which patients received either usual care by a general practitioner (information and analgesics), or placebo physiotherapy given by a physiotherapist, or exercise therapy given by a physiotherapist.

Objective: To assess the efficacy of exercise therapy on sickness absence from work in patients with acute low back pain.

Summary of background data: Exercise therapy during the nonchronic phase of back pain is considered to reduce sickness absence, but this opinion is controversial.

Methods: Patients with acute nonspecific low back pain and a paid job were included for analysis. Sickness absence (number of days) was checked monthly during the 1-year follow-up period and compliance was also assessed.

Results: From 40 general practices 363 patients who were gainfully employed were included. In the exercise therapy group the percentage of patients with sickness absence was higher and the duration of absence was longer than in the placebo and usual care groups, but these differences were not significant. Indications of more absence in the exercise therapy group appeared to be based largely on a greater number of patients with absences during the first 3 months. Patients in the exercise group who had not reported sick at entry had more sickness absences during the follow-up year than patients in the usual care and placebo group. Good compliance did not affect the results.

Conclusions: Exercise therapy for patients with acute low back pain does not reduce sickness absence.